scholarly journals Cognitive Dysfunction and Survival in Hospitalized Patients with Delirium: A 12-Month Prospective Cohort Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mousa Kiani Chelmardi ◽  
Raheleh Rafaiee ◽  
Seyed Davood Hosseini Talari ◽  
Nadia Abedi Omali ◽  
Seyed Hamzeh Hosseini
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cognitive Status ◽  
Negative Effects ◽  
Post Discharge ◽  
One Year

Background: The effect of delirium of hospitalized inpatients on post-discharge cognitive status and survival of older patients remains unclear, and little is known about the related risk factors of cognitive impairment after delirium. Objectives: To determine one-year survival of patients with delirium and cognitive dysfunction in elderly inpatients after initial hospital admission. Methods: This prospective cohort study was conducted on 100 patients with delirium admitted to a general hospital from October 2018 to November 2019. Cognitive dysfunction and death were the primary outcomes. The mini-mental state examination (MMSE) was used to measure cognitive function. Results: In this study, 12 patients died in hospital and cumulative three-month mortality was 40%. Finally, 60 patients were followed for one year. The one-year survival rate through the Kaplan-Meyer approach was 31%. The rate of one-year mortality was found with a significant association with underlying parameters, such as cancer (P = 0.008), cirrhosis (P = 0.04), trauma (P = 0.001), BUN ≥ 50 mg/dL (P = 0.02), Cr ≥ 1.2 mg/dL (P = 0.04), hypocalcemia (P = 0.0), and thrombocytopenia (P = 0.002). According to the MMSE scores, participants had normal cognition (46.7%), mild dementia (6.7%), moderate dementia (33.3%), and severe dementia (3.3%). The cognitive impairment showed a significant association with underlying parameters, such as pulmonary infections (P = 0.02), trauma (P = 0.02), and renal failure (P = 0.04). Conclusions: Assessment and screening for delirium is necessary in all older hospitalized inpatients. Cognitive measurement is effective to identify delirium, accelerate proper control, and decrease its negative effects. Family members should be trained and involved in care, particularly for monitoring of risk factors upon discharge.

Risk factors for long‐term cognitive impairment in ICU survivors: A multicenter, prospective cohort study

2020 ◽  
Vol 65 (1) ◽  
pp. 92-99
Author(s):  
Marie O. Collet ◽  
Ingrid Egerod ◽  
Thordis Thomsen ◽  
Jørn Wetterslev ◽  
Theis Lange ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

The Natural Course and Risk Factors for Progression of Diabetic Retinopathy-KNDP Prospective Cohort Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1571-P
Author(s):  
HYUN UK MOON ◽  
JA YOUNG JEON ◽  
SOOJIN LEE ◽  
SEUNG JIN HAN ◽  
HAE JIN KIM ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Natural Course

scholarly journals Prenatal Sociodemographic Factors Predicting Maltreatment of Children up to 3 Years Old: A Prospective Cohort Study Using Administrative Data in Japan

2021 ◽  
Vol 18 (5) ◽  
pp. 2505
Author(s):  
Aya Isumi ◽  
Kunihiko Takahashi ◽  
Takeo Fujiwara
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Child Maltreatment ◽  
Survey Data ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Risk Scores ◽  
Prenatal Risk ◽  
Prenatal Risk Factors

Identifying risk factors from pregnancy is essential for preventing child maltreatment. However, few studies have explored prenatal risk factors assessed at pregnancy registration. This study aimed to identify prenatal risk factors for child maltreatment during the first three years of life using population-level survey data from pregnancy notification forms. This prospective cohort study targeted all mothers and their infants enrolled for a 3- to 4-month-old health check between October 2013 and February 2014 in five municipalities in Aichi Prefecture, Japan, and followed them until the child turned 3 years old. Administrative records of registration with Regional Councils for Children Requiring Care (RCCRC), which is suggestive of child maltreatment cases, were linked with survey data from pregnancy notification forms registered at municipalities (n = 893). Exact logistic regression was used for analysis. A total of 11 children (1.2%) were registered with RCCRC by 3 years of age. Unmarried marital status, history of artificial abortion, and smoking during pregnancy were significantly associated with child maltreatment. Prenatal risk scores calculated as the sum of these prenatal risk factors, ranging from 0 to 7, showed high predictive power (area under receiver operating characteristic curve 0.805; 95% confidence interval (CI), 0.660–0.950) at a cut-off score of 2 (sensitivity = 72.7%, specificity = 83.2%). These findings suggest that variables from pregnancy notification forms may be predictors of the risk for child maltreatment by the age of three.

scholarly journals Early Moves: a protocol for a population-based prospective cohort study to establish general movements as an early biomarker of cognitive impairment in infants

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041695
Author(s):  
Catherine Elliott ◽  
Caroline Alexander ◽  
Alison Salt ◽  
Alicia J Spittle ◽  
Roslyn N Boyd ◽  
...  
Keyword(s):  
At Risk ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Research Ethics ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Ethics Committee ◽  
Research Ethics Committee ◽  
National Implementation ◽  
General Movements

IntroductionThe current diagnostic pathways for cognitive impairment rarely identify babies at risk before 2 years of age. Very early detection and timely targeted intervention has potential to improve outcomes for these children and support them to reach their full life potential. Early Moves aims to identify early biomarkers, including general movements (GMs), for babies at risk of cognitive impairment, allowing early intervention within critical developmental windows to enable these children to have the best possible start to life.Method and analysisEarly Moves is a double-masked prospective cohort study that will recruit 3000 term and preterm babies from a secondary care setting. Early Moves will determine the diagnostic value of abnormal GMs (at writhing and fidgety age) for mild, moderate and severe cognitive delay at 2 years measured by the Bayley-4. Parents will use the Baby Moves smartphone application to video their babies’ GMs. Trained GMs assessors will be masked to any risk factors and assessors of the primary outcome will be masked to the GMs result. Automated scoring of GMs will be developed through applying machine-based learning to the data and the predictive value for an abnormal GM will be investigated. Screening algorithms for identification of children at risk of cognitive impairment, using the GM assessment (GMA), and routinely collected social and environmental profile data will be developed to allow more accurate prediction of cognitive outcome at 2 years. A cost evaluation for GMA implementation in preparation for national implementation will be undertaken including exploring the relationship between cognitive status and healthcare utilisation, medical costs, health-related quality of life and caregiver burden.Ethics and disseminationEthics approval has been granted by the Medical Research Ethics Committee of Joondalup Health Services and the Health Service Human Research Ethics Committee (1902) of Curtin University (HRE2019-0739).Trial registration numberACTRN12619001422112.

Inter-observer reliability of a risk assessment model for venous thromboembolism in acutely-ill medical hospitalized patients: Results from a prospective cohort study

2021 ◽  
pp. 026835552110212
Author(s):  
Cassia RL Ferreira ◽  
Marcos de Bastos ◽  
Mirella L Diniz ◽  
Renan A Mancini ◽  
Yan S Raposo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Risk Classification ◽  
Assessment Model ◽  
Kappa Statistics ◽  
Medical Patients ◽  
Observer Reliability

Objectives To analyze the inter-observer reliability of risk for venous thromboembolism (VTE) in a population of adult acutely-ill medical patients. Methods In this prospective cohort study, we collected risk factors and risk classification for VTE using RAM IMPROVE7. Kappa statistics was used to evaluate inter-observer reliability between lead clinicians and trained researchers. We evaluated occurrence of VTE in patients with mismatched classification. Results We included 2,380 patients, median age 70 years (interquartile range [IQR], 58-79), 56.2% female. Adjusted Kappa for VTE risk factors ranged from substantial (0.64, 95% confidence interval [CI], 0.61-0.67) for “immobilization”, to almost perfect (0.98; 95% CI 0.97-0.99) for “thrombophilia”; risk classification was 0.64 (95% CI 0.60-0.67). Divergent risk classification occurred in 434 patients (18.2%) of whom seven (1.6%) developed VTE. Conclusion Despite substantial to almost perfect reliability between observers for risk factors and risk classification, lead clinicians tended to underestimate the risk for VTE.

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